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The findings from the saliva examinations in children provided parents with evidence of how the infection could be affecting their children, even in the absence of obvious illness at the time. Subclinical infections are important.
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They may contribute to continuing dengue transmission, as well as to the emergence of serious forms of the illness. Previous studies show that co-circulation of DENV strands increases the risk of epidemics and serious dengue cases [ 28 ].
Other authors have reported a similar age gradient, and it may be that older adults have developed some level of immunity, having been exposed to all four serotypes—and been infected by at least one of them—over a longer period of time [ 29 ]. The higher rate of recognized dengue cases among the older children may be because older children are better at reporting symptoms; among younger children parents may confuse dengue fever with other health problems, such as a respiratory infection.
Sharing the findings from the saliva samples helped to sensitize parents about the high rate of dengue infections among young children, which may go unrecognized even if they cause some non-specific symptoms. In smaller less than 5 people households, households where the head was working, and households with a more educated head, the increased reporting of dengue cases may be because there is better recognition of cases of dengue illness.
A study in Brazil reported an association between higher income and a higher risk of dengue haemorrhagic fever [ 30 ], and a study in Thailand reported a higher risk of dengue among more educated households [ 31 ].
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Anti-mosquito products Use of anti-mosquito products was associated with self-reported cases of dengue illness in all three regions. Cause and effect in such associations are difficult to determine in cross-sectional studies. In the Mexican system of dengue prevention and control, health workers visit households with a recognized case of dengue fever to place temephos in the water and fumigate in the area [ 32 ]; this may sensitize households and lead them to increase their use of anti-mosquito products.
Additional analysis of the baseline study highlighted high amounts being spent by households in anti-mosquito products [ 33 ], and the Camino Verde intervention emphasized non-chemical methods of vector control. In the mainly rural Costa Grande and Costa Chica regions, customs are more traditional and women spend more time at home where they may be more exposed to the Aedes aegypti mosquito which prefers to breed in domestic settings.
As it turned out, in Mexico women were much more active than men in community activities to reduce mosquitoes during the Camino Verde trial [ 34 ]; one reason for their greater involvement may be that they perceived themselves as more affected by dengue. Limitations We identified cases of dengue on the basis of self-reports from the household respondent in each household.
Such reports may not be fully reliable. Under-reporting of dengue cases may have been more marked in some households, as discussed above.
We did not ask about the severity of symptoms, although we did collect information about whether cases had been admitted to hospital for treatment [ 35 ]. As with all cross-sectional analyses, we cannot interpret the associations we identified in our analysis as being causal. Conclusions Findings from the baseline study of the Camino Verde trial confirmed and highlighted associations with dengue virus infection and with self-reported dengue illness.
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Discussion and dissemination of evidence from the baseline survey were integral to the intervention in the trial communities. The weakness of community leadership and the relatively low rates of self-reported dengue illness were challenges that the Mexican intervention team had to overcome.
Results We conducted entomological inspections in 11, households. Among 45, water containers examined, 6. Both covering water containers and inserting temephos were independently associated with a lower risk of presence of larvae or pupae, with the effect of covering OR 0. Having more than four water containers was associated with household infestation in both rural areas OR 1.
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Additional factors in rural areas were: household head without paid work 1. In urban areas only, presence of temephos was associated with a lower risk of household infestation 0. Conclusion Concrete tanks and barrels accounted for the majority of pupal productivity. Covering water containers could be an effective means of Ae. These findings were useful in planning and implementing the Camino Verde trial intervention in Mexico.
Keywords: Aedes aegypti, Dengue, Pupal productivity, Temephos Background Dengue is an important neglected infectious disease in the Latin America and Caribbean region [ 1 ]. Globally, there are an estimated million dengue infections a year, of which 96 million show clinical manifestations ranging from mild to the most severe [ 2 ].
The main dengue vector is the Aedes aegypti mosquito, which is drawn to urban habitats and reproduces mainly in artificial water containers inside or outside households [ 3 ]. Irregular or low-quality household water supplies compel households to store water in tanks, barrels or other containers, often open, thus creating a favourable environment for the female Ae. Low quality urban development contributes to the proliferation of containers in which Ae. Many types of container can become breeding sites [ 8 ], and their contribution to mosquito production may vary depending on the season [ 9 , 10 ].
Certain household characteristics have been identified as adding to the risk of infestation by immature forms of Ae. This article reports an analysis of data from the baseline survey for Camino Verde, a cluster-randomised controlled trial to reduce dengue risk in southern Mexico and Nicaragua through evidence-based community mobilisation, conducted in and described by Andersson et al.
Other community mobilisation interventions have shown impact on entomological indicators; Camino Verde was the first to have demonstrated impact against dengue virus infection and reported cases of dengue illness. The baseline for the Mexican arm of the trial collected information from households in 90 clusters, representative of the three coastal regions of Guerrero State.
Findings from the baseline regarding the Ae.
This article describes the types of water containers found in the households, documents the levels of infestation with Ae. The methods of the baseline study for the trial are described in detail elsewhere [ 13 , 15 ]. There were three elements: a community profile, based on observation and interviews with key informants, which documented relevant characteristics of each community; a household survey administered to a respondent in each household an average of households per cluster ; and an entomological survey of each household.El Camino College Union.
In the Mexican system of dengue prevention and control, health workers visit households with a recognized case of dengue fever to place temephos in the water and fumigate in the area [ 32 ]; this may sensitize households and lead them to increase their use of anti-mosquito products.
Findings from the baseline regarding the Ae. To file a notice of infringement with us, you must provide us with the items specified below.
Abstract Background Understanding the breeding patterns of Aedes aegypti in households and the factors associated with infestation are important for implementing vector control. Known for its innovation, creativity and artistic ability, MOSAIC has been designated one of the most influential and innovative churches in America.
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El hecho que siga siendo best seller testimonio cun meditada meticulosa crtica socialismo las economas planificacin centralizada. Their field supervisors also had entomological experience.
Discussion and dissemination of evidence from the baseline survey were integral to the intervention in the trial communities.